Extended criteria (experimental). This is the broader ten-condition engine, kept as a secondary area. It shows ICD-10-CM codes and illustrative grouping effects for CDI staff. The primary surface is Before you sign (kidney, measurement only). All extended pages.

ENC-00074: Ximena Bellweather

87M · MRN38962018 · Hospital Medicine · admitted Tue Nov 10, 2026 02:08 PM · in hospital · attending Dr. Rosalind Quillan · resident Dr. Priya Thorne · 177 cm, 133.3 kg

Documented diagnoses (current)

Principal: “sepsis” · A41.9 Sepsis, unspecified organism
“community-acquired pneumonia” · J18.9 Pneumonia, unspecified organism
“obesity” · E66.9 Obesity, unspecified
“hypertension” · I10 Essential (primary) hypertension
“type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications

Illustrative grouping now: MS-DRG 871 Septicemia or severe sepsis without MV >96 hours with MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 871.

Queries and events

No queries yet.

All rules applied

Rule Criteria Finding Outcome

Acute kidney injury

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule aki v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: meets_definition	`creat_ratio >= t.ratio_s1 or creat_rise_48h >= t.rise_abs or coalesce(uo_hours_lt_0_5 >= t.uo_s1_h, false)`	creat_ratio=1.023, t.ratio_s1=1.5, creat_rise_48h=0.02, t.rise_abs=0.3, uo_hours_lt_0_5=unknown, t.uo_s1_h=6	false
derived: stage3	`meets_definition and (creat_ratio >= t.ratio_s3 or creat_peak >= t.scr_s3 or rrt_started or coalesce(uo_hours_lt_0_3 >= t.uo_s3_h, false) or coalesce(anuria_hours >= t.anuria_h, false))`	meets_definition=False, creat_ratio=1.023, t.ratio_s3=3.0, creat_peak=0.88, t.scr_s3=4.0, rrt_started=False, uo_hours_lt_0_3=unknown, t.uo_s3_h=24, anuria_hours=unknown, t.anuria_h=12	false
derived: stage2	`creat_ratio >= t.ratio_s2 or coalesce(uo_hours_lt_0_5 >= t.uo_s2_h, false)`	creat_ratio=1.023, t.ratio_s2=2.0, uo_hours_lt_0_5=unknown, t.uo_s2_h=12	false
derived: stage	`case(stage3, 3, stage2, 2, meets_definition, 1, 0)`	stage3=False, stage2=False, meets_definition=False	0
derived: baseline_independent	`creat_baseline_known or creat_rise_48h >= t.rise_abs or rrt_started`	creat_baseline_known=True, creat_rise_48h=0.02, t.rise_abs=0.3, rrt_started=False	true
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=0, baseline_independent=True	false
outcome: aki_presumed_baseline	`stage >= 1`	stage=0	false
outcome: not_met	`stage == 0`	stage=0	true

Acute blood loss anaemia

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule blood_loss_anemia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: anaemic	`case(sex == 'M', hgb_nadir < t.hb_m, sex == 'F', hgb_nadir < t.hb_f, null)`	sex=M, hgb_nadir=14.36, t.hb_m=13, t.hb_f=12	false
derived: acute_fall	`hgb_drop >= t.drop_major or prbc_units >= t.prbc_major`	hgb_drop=0.5, t.drop_major=2.0, prbc_units=0, t.prbc_major=2	false
outcome: met	`bleeding_documented and anaemic and acute_fall`	bleeding_documented=False, anaemic=False, acute_fall=False	false
outcome: anaemia_only	`anaemic and hgb_drop < t.drop_min and prbc_units == 0`	anaemic=False, hgb_drop=0.5, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=14.36, anaemic=False	true

Chronic kidney disease

Clinical judgement required

No gap

Not documented; egfr 60 or above; ckd g1-g2 requires markers of kidney damage, which are not assessed here.

Trace

Rule trace (rule ckd v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: chronic	`egfr_n >= 2 and egfr_span_days >= t.chronic_days`	egfr_n=2, egfr_span_days=259, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=84.7, egfr_late=83.8	84.7
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=84.7, t.g2=60, egfr_late=83.8	false
derived: category	`case(staging_egfr >= t.g2, 'G1-G2', staging_egfr >= t.g3a, 'G3a', staging_egfr >= t.g3b, 'G3b', staging_egfr >= t.g4, 'G4', 'G5')`	staging_egfr=84.7, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15	G1-G2
outcome: duration_not_shown	`not chronic`	chronic=True	false
outcome: straddles_60	`not both_below_60 and min(egfr_early, egfr_late) < t.g2`	both_below_60=False, egfr_early=84.7, egfr_late=83.8, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=84.7, t.g2=60	true

Heart failure

Clinical judgement required

No gap

Not documented; only one acute indicator; acuity needs clinical judgement.

Trace

Rule trace (rule heart_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: np_elevated	`coalesce(bnp_max >= t.bnp, false) or coalesce(ntprobnp_max >= t.ntprobnp, false)`	bnp_max=unknown, t.bnp=100, ntprobnp_max=unknown, t.ntprobnp=300	false
derived: acute_count	`count(iv_loop_diuretic, np_elevated, new_o2)`	iv_loop_diuretic=False, np_elevated=False, new_o2=True	1
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=unknown, t.ref=40, t.pres=50	unknown
derived: improved	`coalesce(lvef_prior_min <= t.ref and lvef > t.ref and lvef - lvef_prior_min >= t.improved_rise, false)`	lvef_prior_min=unknown, t.ref=40, lvef=unknown, t.improved_rise=10	false
derived: acuity	`case(acute_count >= 2 and hf_history, 'acute on chronic', acute_count >= 2, 'acute', acute_count == 0 and hf_history, 'chronic', null)`	acute_count=1, hf_history=False	unknown
outcome: improved_ef	`improved`	improved=False	false
outcome: midrange	`hf_type == 'midrange'`	hf_type=unknown	unknown
outcome: sys_aoc	`hf_type == 'systolic' and acuity == 'acute on chronic'`	hf_type=unknown, acuity=unknown	unknown
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=unknown, acuity=unknown	unknown
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=unknown, acuity=unknown	unknown
outcome: dia_aoc	`hf_type == 'diastolic' and acuity == 'acute on chronic'`	hf_type=unknown, acuity=unknown	unknown
outcome: dia_acute	`hf_type == 'diastolic' and acuity == 'acute'`	hf_type=unknown, acuity=unknown	unknown
outcome: dia_chronic	`hf_type == 'diastolic' and acuity == 'chronic'`	hf_type=unknown, acuity=unknown	unknown
outcome: one_indicator	`acute_count == 1`	acute_count=1	true

Hyponatraemia

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule hyponatremia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: severity	`case(na_min < t.profound, 'profound', na_min < t.moderate, 'moderate', na_min < t.low, 'mild', 'none')`	na_min=137.0, t.profound=125, t.moderate=130, t.low=135	none
outcome: met	`na_min < t.low and na_low_count >= t.repeat and na_treated`	na_min=137.0, t.low=135, na_low_count=0, t.repeat=2, na_treated=False	false
outcome: untreated	`na_min < t.low`	na_min=137.0, t.low=135	false
outcome: not_met	`na_min >= t.low`	na_min=137.0, t.low=135	true

Malnutrition

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule malnutrition v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: a_sev_intake	`intake_pct <= t.a_sev_intake_pct and intake_days >= t.a_sev_intake_days`	intake_pct=100.0, t.a_sev_intake_pct=50, intake_days=unknown, t.a_sev_intake_days=5	false
derived: a_mod_intake	`intake_pct < t.a_mod_intake_pct and intake_days > t.a_mod_intake_days`	intake_pct=100.0, t.a_mod_intake_pct=75, intake_days=unknown, t.a_mod_intake_days=7	false
derived: a_sev_wt	`(wt_loss_days <= 7 and wt_loss_pct > 2) or (wt_loss_days <= 31 and wt_loss_pct > 5) or (wt_loss_days <= 92 and wt_loss_pct > 7.5)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: a_mod_wt	`(wt_loss_days <= 7 and wt_loss_pct >= 1) or (wt_loss_days <= 31 and wt_loss_pct >= 5) or (wt_loss_days <= 92 and wt_loss_pct >= 7.5)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: c_sev_intake	`intake_pct <= t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=100.0, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	false
derived: c_mod_intake	`intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=100.0, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	false
derived: c_sev_wt	`(wt_loss_days <= 31 and wt_loss_pct > 5) or (wt_loss_days <= 92 and wt_loss_pct > 7.5) or (wt_loss_days <= 183 and wt_loss_pct > 10) or (wt_loss_days <= 366 and wt_loss_pct > 20)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: c_mod_wt	`(wt_loss_days <= 31 and wt_loss_pct >= 5) or (wt_loss_days <= 92 and wt_loss_pct >= 7.5) or (wt_loss_days <= 183 and wt_loss_pct >= 10) or (wt_loss_days <= 366 and wt_loss_pct >= 20)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: n_assessed	`known(intake_pct, wt_loss_pct, fat_loss, muscle_loss, fluid, grip_reduced)`	intake_pct=100.0, wt_loss_pct=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown	4
derived: n_severe	`case(nutr_context == 'acute', count(a_sev_intake, a_sev_wt, fat_loss >= 2, muscle_loss >= 2, fluid >= 2, grip_reduced), nutr_context == 'chronic', count(c_sev_intake, c_sev_wt, fat_loss >= 3, muscle_loss >= 3, fluid >= 3, grip_reduced), null)`	nutr_context=acute, a_sev_intake=False, a_sev_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_sev_wt=unknown	0
derived: n_moderate	`case(nutr_context == 'acute', count(a_sev_intake or a_mod_intake, a_sev_wt or a_mod_wt, fat_loss >= 1, muscle_loss >= 1, fluid >= 1, grip_reduced), nutr_context == 'chronic', count(c_sev_intake or c_mod_intake, c_sev_wt or c_mod_wt, fat_loss >= 1, muscle_loss >= 1, fluid >= 1, grip_reduced), null)`	nutr_context=acute, a_sev_intake=False, a_mod_intake=False, a_sev_wt=unknown, a_mod_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_mod_intake=False, c_sev_wt=unknown, c_mod_wt=unknown	0
outcome: severe	`n_severe >= 2`	n_severe=0	false
outcome: moderate	`n_moderate >= 2`	n_moderate=0	false
outcome: one_characteristic	`n_moderate == 1`	n_moderate=0	false
outcome: not_met	`n_moderate == 0 and n_assessed >= 2`	n_moderate=0, n_assessed=4	true

Obesity

Criteria met

Specificity gap

Documented “obesity” (E66.9); criteria support the more specific Obesity, class 3 (E66.813).

Trace

Rule trace (rule obesity v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
outcome: not_adult	`age < t.adult`	age=87, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=42.5, t.c3=40	true

Pressure injury

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

Trace

Rule trace (rule pressure_injury v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: sacral	`wound_site == 'sacral'`	wound_site=unknown	unknown
outcome: no_wound_note	`not present(wound_stage)`	wound_stage=unknown	true

Acute respiratory failure

Criteria met

Specificity gap

Criteria support Acute respiratory failure with hypoxia (J96.01); no corresponding diagnosis is documented.

Trace

Rule trace (rule respiratory_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: measured	`present(spo2_min_ra) or present(pao2_min_ra) or present(pf_min)`	spo2_min_ra=84.0, pao2_min_ra=unknown, pf_min=unknown	true
derived: hypoxemia	`coalesce(spo2_min_ra < t.spo2_ra, false) or coalesce(pao2_min_ra < t.pao2, false) or coalesce(pf_min < t.pf, false)`	spo2_min_ra=84.0, t.spo2_ra=88, pao2_min_ra=unknown, t.pao2=60, pf_min=unknown, t.pf=300	true
derived: distress	`coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support`	rr_max=32.0, t.rr_distress=28, wob_increased=True, adv_resp_support=False	true
outcome: chronic_baseline	`home_o2 and hypoxemia`	home_o2=False, hypoxemia=True	false
outcome: met	`hypoxemia and distress`	hypoxemia=True, distress=True	true

Sepsis

Criteria met

No gap

Supported as documented (A41.9).

Trace

Rule trace (rule sepsis v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: sirs_temp	`coalesce(temp_max_48h > t.t_hi, false) or coalesce(temp_min_48h < t.t_lo, false)`	temp_max_48h=39.3, t.t_hi=38, temp_min_48h=38.4, t.t_lo=36	true
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=120.0, t.hr=90	true
derived: sirs_rr	`coalesce(rr_max_48h > t.rr, false) or coalesce(paco2_min_48h < t.paco2, false)`	rr_max_48h=32.0, t.rr=20, paco2_min_48h=unknown, t.paco2=32	true
derived: sirs_wbc	`coalesce(wbc_max_48h > t.wbc_hi, false) or coalesce(wbc_min_48h < t.wbc_lo, false) or coalesce(bands_max_48h > t.bands, false)`	wbc_max_48h=15.68, t.wbc_hi=12, wbc_min_48h=14.67, t.wbc_lo=4, bands_max_48h=unknown, t.bands=10	true
derived: sirs_count	`count(sirs_temp, sirs_hr, sirs_rr, sirs_wbc)`	sirs_temp=True, sirs_hr=True, sirs_rr=True, sirs_wbc=True	4
derived: sofa_resp	`coalesce(case(pf_min_48h < 100 and adv_resp_support, 4, pf_min_48h < 200 and adv_resp_support, 3, pf_min_48h < 300, 2, pf_min_48h < 400, 1, 0), 0)`	pf_min_48h=unknown, adv_resp_support=False	0
derived: sofa_coag	`coalesce(case(platelets_min_48h < 20, 4, platelets_min_48h < 50, 3, platelets_min_48h < 100, 2, platelets_min_48h < 150, 1, 0), 0)`	platelets_min_48h=82.0	2
derived: sofa_liver	`coalesce(case(bili_max_48h >= 12, 4, bili_max_48h >= 6, 3, bili_max_48h >= 2, 2, bili_max_48h >= 1.2, 1, 0), 0)`	bili_max_48h=0.65	0
derived: sofa_cardio	`coalesce(case(norepi_max_48h > 0.1, 4, norepi_max_48h > 0, 3, map_min_48h < 70, 1, 0), 0)`	norepi_max_48h=0.0, map_min_48h=64.0	1
derived: sofa_cns	`coalesce(case(gcs_min_48h < 6, 4, gcs_min_48h < 10, 3, gcs_min_48h < 13, 2, gcs_min_48h < 15, 1, 0), 0)`	gcs_min_48h=15.0	0
derived: sofa_renal	`coalesce(case(creat_max_48h >= 5, 4, creat_max_48h >= 3.5, 3, creat_max_48h >= 2, 2, creat_max_48h >= 1.2, 1, 0), 0)`	creat_max_48h=0.88	0
derived: sofa_renal_baseline	`coalesce(case(creat_baseline >= 5, 4, creat_baseline >= 3.5, 3, creat_baseline >= 2, 2, creat_baseline >= 1.2, 1, 0), 0)`	creat_baseline=0.86	0
derived: sofa_delta	`sofa_resp + sofa_coag + sofa_liver + sofa_cardio + sofa_cns + sofa_renal - sofa_renal_baseline`	sofa_resp=0, sofa_coag=2, sofa_liver=0, sofa_cardio=1, sofa_cns=0, sofa_renal=0, sofa_renal_baseline=0	3
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=True, sofa_delta=3, t.sofa_delta=2	true
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=True, sirs_count=4, t.sirs_min=2	true
derived: shock	`sepsis3 and norepi_max_48h > 0 and coalesce(lactate_max_48h > t.lactate, false)`	sepsis3=True, norepi_max_48h=0.0, lactate_max_48h=2.69, t.lactate=2	false
outcome: no_infection	`not infection_documented`	infection_documented=True	false
outcome: septic_shock	`shock`	shock=False	false
outcome: both	`sepsis3 and sepsis2`	sepsis3=True, sepsis2=True	true

Structured data

Labs (24)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-002515	Sun Jan 18, 2026 09:15 AM	creatinine	0.83 mg/dL
LAB-002516	Mon Oct 05, 2026 10:05 AM	creatinine	0.86 mg/dL
LAB-002517	Tue Nov 10, 2026 03:08 PM	creatinine	0.86 mg/dL
LAB-002521	Tue Nov 10, 2026 03:08 PM	sodium	138.0 mmol/L
LAB-002525	Tue Nov 10, 2026 03:08 PM	hemoglobin	14.43 g/dL
LAB-002529	Tue Nov 10, 2026 03:08 PM	wbc	15.55 x10^3/uL
LAB-002530	Tue Nov 10, 2026 03:08 PM	platelets	85.0 x10^3/uL
LAB-002537	Tue Nov 10, 2026 03:08 PM	bilirubin	0.65 mg/dL
LAB-002538	Tue Nov 10, 2026 03:08 PM	lactate	2.69 mmol/L
LAB-002518	Wed Nov 11, 2026 05:00 AM	creatinine	0.88 mg/dL
LAB-002522	Wed Nov 11, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-002526	Wed Nov 11, 2026 05:00 AM	hemoglobin	14.49 g/dL
LAB-002531	Wed Nov 11, 2026 05:00 AM	wbc	14.67 x10^3/uL
LAB-002532	Wed Nov 11, 2026 05:00 AM	platelets	85.0 x10^3/uL
LAB-002519	Thu Nov 12, 2026 05:00 AM	creatinine	0.86 mg/dL
LAB-002523	Thu Nov 12, 2026 05:00 AM	sodium	137.0 mmol/L
LAB-002527	Thu Nov 12, 2026 05:00 AM	hemoglobin	14.87 g/dL
LAB-002533	Thu Nov 12, 2026 05:00 AM	wbc	15.68 x10^3/uL
LAB-002534	Thu Nov 12, 2026 05:00 AM	platelets	82.0 x10^3/uL
LAB-002520	Fri Nov 13, 2026 05:00 AM	creatinine	0.86 mg/dL
LAB-002524	Fri Nov 13, 2026 05:00 AM	sodium	139.0 mmol/L
LAB-002528	Fri Nov 13, 2026 05:00 AM	hemoglobin	14.36 g/dL
LAB-002535	Fri Nov 13, 2026 05:00 AM	wbc	8.68 x10^3/uL
LAB-002536	Fri Nov 13, 2026 05:00 AM	platelets	281.0 x10^3/uL

Vitals (70)

Vitals
Row	When	Kind	Value	Detail
VIT-007258	Tue Nov 10, 2026 02:28 PM	spo2	84.0	room air
VIT-007259	Tue Nov 10, 2026 02:28 PM	rr	32.0
VIT-007288	Tue Nov 10, 2026 02:28 PM	temp_c	39.3
VIT-007289	Tue Nov 10, 2026 02:28 PM	hr	120.0
VIT-007290	Tue Nov 10, 2026 02:28 PM	map	67.0
VIT-007291	Tue Nov 10, 2026 02:28 PM	gcs	15.0
VIT-007260	Tue Nov 10, 2026 02:38 PM	o2_lpm	5.0	nasal cannula
VIT-007261	Tue Nov 10, 2026 10:28 PM	spo2	94.0	nasal cannula
VIT-007262	Tue Nov 10, 2026 10:28 PM	rr	26.0
VIT-007263	Tue Nov 10, 2026 10:28 PM	o2_lpm	2.0	nasal cannula
VIT-007292	Tue Nov 10, 2026 10:28 PM	temp_c	38.4
VIT-007293	Tue Nov 10, 2026 10:28 PM	hr	114.0
VIT-007294	Tue Nov 10, 2026 10:28 PM	map	68.0
VIT-007295	Tue Nov 10, 2026 10:28 PM	gcs	15.0
VIT-007264	Wed Nov 11, 2026 06:28 AM	spo2	93.0	nasal cannula
VIT-007265	Wed Nov 11, 2026 06:28 AM	rr	26.0
VIT-007266	Wed Nov 11, 2026 06:28 AM	o2_lpm	4.0	nasal cannula
VIT-007296	Wed Nov 11, 2026 06:28 AM	temp_c	38.7
VIT-007297	Wed Nov 11, 2026 06:28 AM	hr	120.0
VIT-007298	Wed Nov 11, 2026 06:28 AM	map	65.0
VIT-007299	Wed Nov 11, 2026 06:28 AM	gcs	15.0
VIT-007267	Wed Nov 11, 2026 02:28 PM	spo2	92.0	nasal cannula
VIT-007268	Wed Nov 11, 2026 02:28 PM	rr	26.0
VIT-007269	Wed Nov 11, 2026 02:28 PM	o2_lpm	3.0	nasal cannula
VIT-007300	Wed Nov 11, 2026 02:28 PM	temp_c	39.1
VIT-007301	Wed Nov 11, 2026 02:28 PM	hr	111.0
VIT-007302	Wed Nov 11, 2026 02:28 PM	map	64.0
VIT-007303	Wed Nov 11, 2026 02:28 PM	gcs	15.0
VIT-007270	Wed Nov 11, 2026 10:28 PM	spo2	92.0	nasal cannula
VIT-007271	Wed Nov 11, 2026 10:28 PM	rr	24.0
VIT-007272	Wed Nov 11, 2026 10:28 PM	o2_lpm	4.0	nasal cannula
VIT-007304	Wed Nov 11, 2026 10:28 PM	temp_c	39.1
VIT-007305	Wed Nov 11, 2026 10:28 PM	hr	120.0
VIT-007306	Wed Nov 11, 2026 10:28 PM	map	68.0
VIT-007307	Wed Nov 11, 2026 10:28 PM	gcs	15.0
VIT-007273	Thu Nov 12, 2026 06:28 AM	spo2	93.0	nasal cannula
VIT-007274	Thu Nov 12, 2026 06:28 AM	rr	26.0
VIT-007275	Thu Nov 12, 2026 06:28 AM	o2_lpm	3.0	nasal cannula
VIT-007308	Thu Nov 12, 2026 06:28 AM	temp_c	38.5
VIT-007309	Thu Nov 12, 2026 06:28 AM	hr	113.0
VIT-007310	Thu Nov 12, 2026 06:28 AM	map	66.0
VIT-007311	Thu Nov 12, 2026 06:28 AM	gcs	15.0
VIT-007276	Thu Nov 12, 2026 02:28 PM	spo2	91.0	nasal cannula
VIT-007277	Thu Nov 12, 2026 02:28 PM	rr	22.0
VIT-007278	Thu Nov 12, 2026 02:28 PM	o2_lpm	2.0	nasal cannula
VIT-007312	Thu Nov 12, 2026 02:28 PM	temp_c	37.1
VIT-007313	Thu Nov 12, 2026 02:28 PM	hr	69.0
VIT-007314	Thu Nov 12, 2026 02:28 PM	map	80.0
VIT-007315	Thu Nov 12, 2026 02:28 PM	gcs	15.0
VIT-007279	Thu Nov 12, 2026 10:28 PM	spo2	91.0	nasal cannula
VIT-007280	Thu Nov 12, 2026 10:28 PM	rr	23.0
VIT-007281	Thu Nov 12, 2026 10:28 PM	o2_lpm	2.0	nasal cannula
VIT-007316	Thu Nov 12, 2026 10:28 PM	temp_c	37.5
VIT-007317	Thu Nov 12, 2026 10:28 PM	hr	76.0
VIT-007318	Thu Nov 12, 2026 10:28 PM	map	77.0
VIT-007319	Thu Nov 12, 2026 10:28 PM	gcs	15.0
VIT-007282	Fri Nov 13, 2026 06:28 AM	spo2	92.0	nasal cannula
VIT-007283	Fri Nov 13, 2026 06:28 AM	rr	25.0
VIT-007284	Fri Nov 13, 2026 06:28 AM	o2_lpm	3.0	nasal cannula
VIT-007320	Fri Nov 13, 2026 06:28 AM	temp_c	37.3
VIT-007321	Fri Nov 13, 2026 06:28 AM	hr	90.0
VIT-007322	Fri Nov 13, 2026 06:28 AM	map	87.0
VIT-007323	Fri Nov 13, 2026 06:28 AM	gcs	15.0
VIT-007285	Fri Nov 13, 2026 02:28 PM	spo2	94.0	nasal cannula
VIT-007286	Fri Nov 13, 2026 02:28 PM	rr	23.0
VIT-007287	Fri Nov 13, 2026 02:28 PM	o2_lpm	2.0	nasal cannula
VIT-007324	Fri Nov 13, 2026 02:28 PM	temp_c	36.6
VIT-007325	Fri Nov 13, 2026 02:28 PM	hr	81.0
VIT-007326	Fri Nov 13, 2026 02:28 PM	map	88.0
VIT-007327	Fri Nov 13, 2026 02:28 PM	gcs	15.0

Medications, orders, echo, history (4)

MED-000288 11-10 15:08 piperacillin-tazobactam per protocol IV
MED-000289 11-11 05:00 ceftriaxone per protocol IV
MED-000290 11-12 05:00 ceftriaxone per protocol IV
ORD-000066 11-10 14:38 blood_culture: blood cultures x2

Notes

History and physical · DOC-000256 · Dr. Priya Thorne (resident) · Tue Nov 10, 2026 05:08 PM

Cited facts from this note (2)

infection_source: right lower lobe pneumonia · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… 6-11-10 14:08 Service: Hospital Medicine Attending: Dr. Rosalind Quillan History of present illness: 87-year-old man admitted with sepsis. Chest x-ray shows right lower lobe pneumonia; blood cultures drawn and ceftriaxone started. Past medical history: hypertension, type 2 diabetes. Review of systems otherwise negative. Exam: Lungs: increase …
work_of_breathing: increased · cited p. 1, line 8 · confidence 0.90

Show source for work_of_breathing

… neumonia; blood cultures drawn and ceftriaxone started. Past medical history: hypertension, type 2 diabetes. Review of systems otherwise negative. Exam: Lungs: increased work of breathing with accessory muscle use. Assessment and plan: 1. Sepsis: antibiotics, fluids. 2. Community-acquired pneumonia: antibiotics.

Source document DOC-000256: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Ximena Bellweather   MRN: MRN38962018   Admitted: 2026-11-10 14:08
Service: Hospital Medicine   Attending: Dr. Rosalind Quillan

History of present illness: 87-year-old man admitted with sepsis. Chest x-ray shows right lower lobe pneumonia; blood cultures drawn and ceftriaxone started.
Past medical history: hypertension, type 2 diabetes.
Review of systems otherwise negative.
Exam: Lungs: increased work of breathing with accessory muscle use.
Assessment and plan:
1. Sepsis: antibiotics, fluids.
2. Community-acquired pneumonia: antibiotics.

Nutrition assessment · DOC-000255 · Dario Larkspur, RD (dietitian) · Wed Nov 11, 2026 05:08 PM

Cited facts from this note (5)

fat_loss: none · cited p. 1, line 7 · confidence 0.90

Show source for fat_loss

… MRN: MRN38962018 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
fluid_accumulation: none · cited p. 1, line 7 · confidence 0.90

Show source for fluid_accumulation

… e: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
intake_pct: 100 · cited p. 1, line 5 · confidence 0.90

Show source for intake_pct

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Ximena Bellweather MRN: MRN38962018 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. …
muscle_loss: none · cited p. 1, line 7 · confidence 0.90

Show source for muscle_loss

… acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
nutrition_context: acute · cited p. 1, line 4 · confidence 0.95

Show source for nutrition_context

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Ximena Bellweather MRN: MRN38962018 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle was …

Source document DOC-000255: Nutrition assessment (synthetic)

NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Ximena Bellweather   MRN: MRN38962018

Context: acute illness
Intake: eating 100% of meals.
Weight history: weight stable over the past 3 months.
Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation.
Assessment: well nourished; no malnutrition identified.

Progress note · DOC-000257 · Dr. Priya Thorne (resident) · Fri Nov 13, 2026 01:55 PM · awaiting cosign

Source document DOC-000257: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Ximena Bellweather   MRN: MRN38962018   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Sepsis: continue current management.
2. Obesity: counsel on weight.

Resident: Dr. Priya Thorne   Attending cosign: pending